Director, Claim Support Services

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: Direct the strategic analysis of Claims processes and oversee and ensure the effective operation of Claims Support Services and Claims Projects.

• Oversee Claims Support Services and Claims Projects.
• Oversee the collection, validation and analysis of data to deliver business. solutions ensuring claims payment and quality.
• Monitor performance and develop & implement business solutions to address process and/or quality gaps.
• Promote change through sharing of best practices.
• Leverage automation to achieve desired results.
• Interface with all organizational levels to mobilize commitment.
• Perform claim adjudication project analysis and preparation work flow management.
• Coordinate the implementation of new product or health plan expansions.
• Mentor and develop staff.
• Oversee annual operating plan process and new business initiatives.

Education/Experience: Bachelor's degree in a related area or equivalent experience. 7+ years of experience in claim processing payer support services in healthcare, preferably with Medicaid or equivalent business experience. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff. Previous finance/budget experience preferred.

Pay Range: $103,500.00 - $191,600.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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